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Sports Medicine-Option HSC

Classification of sporting injuries

Wayne Cox

on 13 May 2015

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Transcript of Sports Medicine-Option HSC

Sports Medicine
How are sports injuries classified and managed?
We will be looking at issues of ...........
Injury Prevention
Common Sporting Injuries
Injury assessment
Injury management
Injury Rehabilitation
How are Sports injuries Classified?
Ways to classify a sporting injury

According to cause
According to tissue damage
Soft tissue
Hard tissue
Direct and Indirect Injuries
Injuries caused by DIRECT forces from outside the body resulting in fractures,, dislocations, sprains, strains and contusions or bruising
Direct and Indirect Injuries
Injuries that result from forces generated from outside the body are known as Direct Injuries. Common examples of these include fractures, dislocations, sprains, strains and contusions (bruising). These may occur as a result of a collision, fall or impact from object.
Indirect injuries are caused by Intrinsic or Internal forces. These are forces within the body and may result from inadequate warm up, ballistic or bouncy movements, excessive movement or even a fault in the execution of the skill itself.
They are the result of excessive strain placed on the muscles, tendons and ligaments- resulting in inflamation, irratation and even rupture of tissues and can occur a distance away from the impact site.
Indirect injury examples
Hamstring tear
Stress fractures in the joints of cricketers or gymnasts
Player falling on outstretched arm dislocation clavicle/sternum joint or acromioclavicular joint.
Overuse Injury
These occur when excesive and repetitve force is placed on the bones and other connective tissues of the body.
Little or no pain may be experienced in the initial stages- however -with continued use and performance- micro injuries accumulate and eventually the site becomes inflamed and painful.
Common Overuse injuries
Stress fractures
A stress fracture is an overuse injury. It occurs when muscles become
fatigued and are unable to absorb added shock.

Eventually, the fatigued muscle transfers the overload of stress to the bone ca
using a tiny crack called a stress fracture.

Stress fractures often are the result of increasing the amount or intensity of an activity too rapidly.
They also can be caused by the impact of an unfamiliar surface (a tennis player who has switched surfaces from a soft clay court to a hard court);
improper equipment (a runner using worn or less flexible shoes); and increased physical stress (a basketball player who has had a substantial increase in playing time).
Include- Shin Splints
Symptoms of shin splints:
Pain over the inside lower half of the shin.
Pain at the start of exercise which often eases as the session continues
Pain often returns after activity and may be at its worse the next morning.
Sometimes some swelling.
Lumps and bumps may be felt when feeling the inside of the shin bone.
Pain when the toes or foot are bent downwards.
A redness over the inside of the shin (not always present
Tendonitis is inflammation of a tendon, the fibrous structure that joins the muscle to the bone.

Tendonitis is inflammation of a tendon, the fibrous structure that joins the muscle to the bone.
The most common cause of the condition if overuse or injury.
The areas most commonly affected include shoulders, wrists, elbows, knees and hips.
Treatment includes resting the area and ice packs
Tears, sprains and contusions occur frequently in sport and differ according to the type of damage caused to internal structures
"Tearing of a Ligament"

Ligaments connect Bone to Bone with their primary function being the provision of "joint stability".
Sprains occur when ligaments are damaged altering joint movement as a result of pain.
As a result swelling, pain and loss of function may result as the "inflammatory response" responds to deal with the tear.
Ligament sprains may be classified under three distinct severity levels.
1st Degree
-Little damage
2nd Degree
-Moderate damage
3rd Degree
-Extensive-complete rupture
"Tearing of a Muscle or Tendon"
Like ligament tear classifications - Strains also have 3 grades.
Considerable bleeding pain and discolouration will result from strains. Any muscle movement will result in acute pain and loss of function.
Hard-tissue injuries are those involving damage to the bones of the skeleton. They range from severe fractures and joint dislocations to bruising of the bone. A direct force can bruise a bone and cause bleeding between the outer layer of the bone and the underlying compact bone. This is common in a bone such as the tibia (shin) where there is little muscle tissue over the bone to absorb the force.
Hard-tissue injury

Hard-tissue injuries include fractures and dislocations.
A fracture is a break in a bone. This can result froma direct force, an indirect force or repetitive smaller
impacts (as occurs in a stress fracture). If the skin over a fractured bone is intact, the fracture is described as ‘simple’ or ‘closed’. If the skin over a fracture is broken, the fracture is described as ‘open’ or ‘compound’. The skin might be broken either by the force of the injury that caused the fracture or by a piece of broken bone protruding through the skin.
A fracture is described as ‘complicated’ if nearby tissues and/or organs are damaged.
In some cases, a simple fracture can be difficult to detect. The signs and symptoms of a fracture include:
• pain at the site of the injury
• inability to move the injured part
• unnatural movement of the injured part
• deformity of the injured part
• swelling and discolouration
• grating of bones.
Impact injuries can result in a condition or "bruising". Also known as a"haematoma" or blood tumour-these injuries interrupt blood flow to tissue and can cause pain and subsequently reduce range of movement
Contusions may vary in intensity
Skin abrasions, lacerations and blisters

Classifying sports injuries-Choose from the following injury classifications
Each scenario may have several aspects.

Hard/Soft tissue / Overuse/inirect/Direct

A basketball player jumps for a rebound, lands on another person's foot and tears his knee ligaments.

A 400m hurdler who has trained for a month strains her hamstring halfway through her race.

A child falls from their bike, fracturing their collarbone after putting out their hand to break their fall.

A volleyball player suffers a fracture in the hand when he is hit by the ball in the process of setting.

A skateboarder suffers a broken arm when she falls off the board during a rail trick, hitting the rail.

A rock climber falls and suffers a broken jaw from coming into contact with a rocky outcrop.

A triathlete suffers a stress fracture in his right foot from excessive running and training on hard surfaces.

An athlete develops blisters from ill fitting shoes whilst in training and game play.

A rugby union player suffers bruising to her quadriceps from a defender who uses her shoulder to tackle.

A tennis player develops 'tennis elbow' from repeated practice and game play.
Skin abrasions, lacerations, blisters
Abrasions, lacerations and blisters are other soft tissue injuries. These are skin trauma caused by force (scraping or friction) to the outside layer of the skin.
Skin injuries such as skin abrasions, lacerations and blisters require cleaning and possibly bandaging.
Treatment for Abrasions

Conventional treatment of abrasions and road rash included treating the area by cleaning the wound with mild soap and water or a mild antiseptic wash like hydrogen peroxide, and then covering the area with an antibiotic ointment and a dry dressing.
Deep Lacerations
A laceration is any wound where the flesh has incurred an irregular tear-particular care is needed to avoid infrction.Cuts that continue to bleed after 15 minutes of direct pressure, or cuts that extend deep into the skin and have edges that pull apart, may require stitches. If you are unsure if you need stitches, you should see a physician immediately.
So, Do I Need Stitches?
Lacerations, punctures, and incisions are all suturable wounds (can be stitched). Avulsions that still have a flap of skin attached may also be suturable. Complete avulsions and abrasions are not suturable, but still my need a doctor if they are serious enough.
To determine if stitches are needed, look at three things:

1.Depth. Is the wound deep enough to see the subcutaneous tissue (yellowish fatty tissue)? If so, the wound is deep enough to get stitches, but still may not need them.

2.Width. Can the wound be pulled closed easily? If the wound is gaping and cannot be easily pinched closed, then it will need stitches to hold it closed long enough to heal correctly.

3.Location. Wounds on areas of the body that stretch and move a lot will need stitches more often than those on areas that do not move as much. For example, a wound on the forearm will not move as much as a wound on the calf, so it would not necessarily require stitches.
The healing process of a soft tissue injury involves three phases - the inflammatory stage, repair and regenerative stage, and remodelling stage.

The Inflammatory response
The initial stage of repair of body tissue is the acute inflammatory phase. It exists during the first 24 to 72 hours after injury. The immediate response of the body to injury is to increase the flow of blood and other fluids to the injured site. If blood vessels at the site are damaged there will also be direct bleeding into the surrounding tissue. The accumulation of fluid in the area causes an increase in tissue pressure, which produces pain.
All these changes produce what we call inflammation. Inflammation consists of redness, heat, swelling, pain and loss of function. If inflammation is left unchecked and persists for a long time, formation of scar tissue will be more severe.
- stretching and the application of ice
will limit the formation of scar tissue
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